Cabinet should reconsider GEG law, says MCA deputy secretary-general Pamela Yong

PETALING JAYA: Cabinet should reconsider the generational end-game (GEG) to counter smoking and vaping, says MCA deputy secretary-general Datuk Dr Pamela Yong.

Yong issued a letter on this on Saturday (Dec 9) following the passing of the Control of Smoking Products for Public Health Bill 2023 in Parliament at the end of November with the GEG provisions removed.

In her letter, Yong said that she had witnessed first-hand the devastating health impact of both smoking and vaping as a practicing dental specialist with 18 years of experience.

Yong said that she had treated young patients with advanced gum disease linked directly to smoking, and added that smoking can lead to complications following dental surgery among other serious health issues.

Below is her letter in full:

Last week’s tabling and passage of the Control of Smoking Products for Public Health Bill 2023, stripped of its crucial Generational End Game (GEG) provision, has raised disquiet in regards to the unity government’s true commitment to public health. This decision, shrouded in secrecy and lacking transparency, leaves ample room for ethical concerns and threatens the future health of our nation.

As a practising dental specialist for the last 18 years, I witnessed firsthand the devastating health impact of smoking and vaping daily.

I have treated young patients with advanced gum disease directly linked to smoking. The damage often starts with the teeth, manifesting as a series of visible but superficial symptoms — discolouration, persistent bad breath, and compromised enamel structure. These habits accelerate tooth decay and the onset of periodontal diseases, and even increase the incidence of post-dental surgery complications.

The consequences go far beyond the mouth. Studies have shown that smoking and vaping can significantly damage the respiratory system. They irritate the delicate lining of the lungs, leading to chronic inflammation and increased susceptibility to infections and chronic obstructive pulmonary disease (COPD).

And despite a certain public figure’s wilful disregard of the link between cancer and smoking, an abundance of scientific evidence underscores that the damage from smoking and vaping extends to a deeper cellular level. It is without a shadow of a doubt that smoking and vaping harm DNA, amplifying the risk of cancer not only in the mouth and throat but also in other organs throughout the body.

The generational smoking ban was designed to serve as a progressive and proactive measure to curb the pervasive and long-term impact of tobacco and vape use by restricting access for individuals born from 2007 onward.

By opting for a weakened Bill that fails to address the root cause of smoking addiction, the government is essentially condoning the harm inflicted by cigarettes and vape products, thereby sacrificing the well-being of future generations for short-term gains. Its abrupt removal exposes a disturbing lack of foresight among our nation leaders, and the public deserves full transparency regarding the rationale and ethical considerations behind this decision.

The official reason given by the government was presented in a two-paragraph statement by Attorney-General Ahmad Terrirudin which argues the unconstitutionality of GEG just days before the Bill's tabling.

How the timing itself is a red flag (it denies the public the opportunity for meaningful debate and scrutiny) notwithstanding, the Attorney-General's claim that the GEG provision contravenes Article 8 of the Federal Constitution rests on shaky ground.

Article 8 guarantees equality before the law, yet the GEG provision does not target any specific group. Instead, it aims to protect future generations from the harmful consequences of smoking. Legal experts have questioned the validity of this interpretation, arguing that the provision falls squarely within the government's legitimate power to regulate public health and does not infringe upon fundamental rights.

The arbitrary disregard for the 736-page report by the bipartisan Health Parliamentary Special Select Committee (PSSC) chaired by Dr Dzulkefly Ahmad further highlights a troubling disdain of our lawmakers for evidence-based policymaking and democratic processes.

The comprehensive report was collaboratively put together by a panel involving senior officials from the Attorney-General's Chamber and health experts, and had notably proposed a revised Bill that retained crucial GEG elements. Regrettably, this proposal was inexplicably excluded from parliamentary debate. This not only represents a missed opportunity for substantive discussion but also constitutes a wasteful neglect of resources and undermines the exhaustive effort invested in compiling the report.

Indeed, while this decision to exclude GEG is questionable both democratically and morally, it also presents economic sustainability concerns. Malaysia spends billions of ringgit annually treating smoking-related diseases, a staggering expense that far outweighs the revenue generated from tobacco sales.

In 2020 alone, the Malaysian government spent RM6.2bil treating three major smoking-related diseases, a stark contrast to the RM3bil earned from tobacco sales.

One cannot help but be sceptical about the motivations and considerations that led to the abandonment of a measure aimed at rectifying this unsustainable economic pickle.

Note to the Minister of Health

Dear Dr Zaliha Mustafa, I write this with a heavy heart. Each patient I meet, struggling with the consequences of their addiction, is a stark reminder of the human cost of smoking.

They are not statistics on a page, but real people with families, hopes, and dreams. Each one facing pain, suffering, and a future cut tragically short. It breaks my heart to see them fight recurrent infections, and some battle cancers fuelled by the very same smoke that offered them temporary solace from their addiction.

I trust you, Dr Zaliha, of all people, understand the insidious nature of addiction. You know how it often begins in the innocence of youth, a path paved with misinformation and peer pressure. That is why the Generational End Game (GEG) holds such immense hope. It is a chance to break the cycle, to protect future generations from the very struggles we all in healthcare services witness every day.

Your voice, Dr Zaliha, carries immense weight.

It could be the catalyst for change, the ripple that sets in motion a wave of health and well-being for countless lives. Please, I implore you, in your esteemed capacity as the Minister overseeing public health, advocate within the Cabinet for a reconsideration of the GEG.

Datuk Dr Pamela Yong is also the Chairman of Institute of Strategic Analysis and Policy Research (INSAP) and a practising dental specialist. She has been a dentist for 23 years and actively supports improvement in public healthcare.

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